(CHICAGO) -- Young Medicaid recipients have a harder time getting emergency dental appointments than privately insured youngsters. This is according to a revealing study in which graduate students posed as mothers seeking care for a 10-year-old son who fractured a front tooth in a bicycle accident.
The pretend moms with private insurance coverage got the boys earlier appointments than their counterparts with public insurance.
The findings, published online Monday in the journal Pediatrics, demonstrated that despite efforts to boost the number of patients and providers in the Medicaid system, low-income families still have limited access to dental care -- except when they are able to pay cash.
The study focused on dentists' willingness to provide emergency care to Medicaid patients with front-tooth trauma, a problem that affects one in seven pre-adolescents and nearly one in four teens between the ages of 16 and 19. About 11 percent of these injuries don't get treated, although they ideally should be seen by a dentist within 24 hours.
For each case, graduate-level research assistants from the University of Chicago placed two calls, a month apart, between February and May 2010, to 85 Chicago-area dental practices, 41 of which participated in the Medicaid/Children's Health Insurance Program.
The pretend-moms followed the same script for both calls: Their son was in pain after breaking his front tooth and was advised by an emergency department to seek dental care. The only difference was whether the child had private Blue Cross dental insurance or Medicaid/CHIP. The pretend-moms only revealed the child's insurance status if asked. If the office declined to take their insurance, they asked about paying cash.
Dr. Karin V. Rhodes, an emergency care researcher at the University of Pennsylvania, and colleagues from the Hennepin County Medical Center in Minnesota, Columbia University dental school in New York, and the Children's Dental Health Project in Washington, D.C., set their study in Cook County, Illinois, the nation's second-largest urban county, where fewer than 15 percent of dental practices participate in Medicaid/CHIP.
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